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Introduction to the Community Grievance Decision Digest

General Information

This Community Grievance Decision Digest (CGDD) contains summaries of the decisions made at Level III and Level IV of the DHS 94 patient rights grievance procedure.

Who might find this useful?

The main intended audience is grievance personnel -- client rights specialists and program directors who make decisions at Level IA and IB and county staff who make decisions at Level II of the grievance process.

This digest is intended to give them easily accessible technical assistance in how the patient rights laws and rules are being interpreted at the two highest levels of the grievance process.

While much of the digest is technical in nature, consumers shall also find it helpful to see how grievances issues have been decided at Level III and Level IV of the grievance process.

Who do these decisions apply to?

"Patient" means anyone who is receiving services for mental illness, developmental disabilities, or substance abuse from any provider in Wisconsin. The rights of those "patients" are found in ss. 51.61, Wis. Stats., and DHS 94, Wis. Admin. Code.

The Community Grievance Decision Digest does not apply to anyone receiving services from a state-operated facility. There are separate digests of case decisions for those facilities that are made available only through the DHS internal web site.

What this digest is:

This digest consists of summaries of the patient rights decisions issued at the state levels (Level III and Level IV) of the DHS 94 community grievance process. It does not contain any summaries of decisions made at the provider level (Level I) or the county level (Level II).

(The grievance process is set forth in Subchapter III of DHS 94 (exit DHS; PDF), starting at DHS 94.40, Wis. Admin. Rules. A simplified flow chart (PDF, 5 KB) of the grievance process is available on the Client Rights Internet Site.)

What is the purpose of this Digest?

Each Level III or Level IV grievance decision that sets "precedent" by interpreting the laws and facts applicable to a given situation. These "precedents" are summarized in this digest.

The purpose of setting forth the summary of decision "precedents" is to provide guidance for the interpretation of the patient rights laws and rules.

It is hoped that this digest will promote consistency in decision-making and provide accessible, inexpensive technical assistance to consumers and client rights specialists across the state.

How this Digest is organized:

The law and rules for each specific patient right are set forth first, followed by a brief description of the facts and the outcome of the decisions that interpreted that section of the law. The precedent set by the decision is set forth under the appropriate "rights" category.

However, some cases are complicated and thus set several different precedents. Thus they may be listed under several different categories or even several times under the same category.

Some rights categories do not have any decisions summarized in them.  That is because no issues under that category have been addressed at Level III or Level IV of the DHS 94 grievance process.  The law and rules are still set forth for reference purposes and to provide a framework for future updates of this digest.

Cases are organized by date of the decision, rather than case number. The State Grievance Examiner’s office assigns case numbers upon receipt. The first number is the year the grievance began in.

The middle section is "SGE" for State Grievance Examiner and the last section is the consecutive number of the case. For example: 10-SGE-09 is the 9th Level III grievance received by the SGE in 2010.

What does 'Emphasis Added' mean?

'Emphasis Added' means that certain words in the quoted law or rule have been highlighted in bold to draw attention to them.

Can I get a copy of a Level III or Level IV decision?

Sorry, we cannot provide copies. Due to the amount of details in most of these decisions, it would be nearly impossible to block out all the information that might identify who the individual patient was. Sending out copies of these decisions could violate the consumer's confidentiality rights.

As a client, can I "cite" decision precedents in a complaint?

Yes, you may. CRO intends these precedents to be usable by clients and service providers alike. You need to be aware, however, that the circumstances of your complaint may differ sufficiently from the facts of the case you "cited" so that the precedent may not, upon closer inspection, apply to your specific situation.

As a service provider, can we "cite" decision precedents in response to a complaint?

Yes, you may. CRO intends these precedents to be usable by clients and service providers alike. Level III and Level IV grievance personnel should consistently apply the laws and rules, including our decision precedents, to given fact situations.

If there is a clear precedent and the facts of a grievance are nearly identical, you should be able to rely on the precedents to respond appropriately to any complaints from your clients. The client may still appeal any grievance decision to the state levels.

Will the digest be updated in the future?

The digest will be updated periodically as new decisions are issued. Each section of the digest has a note at the very end about the last time it was updated.

Summary:

The Client Rights Office (CRO) staff hope that both client rights personnel and consumers alike find these precedents helpful. Any questions about them from clients should be addressed to the service provider’s Client Rights staff. We would like the community client rights specialists to be the first line of response. The client rights staff can always ask CRO for further clarification if necessary.

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Last Updated: May 02, 2013